ABSTRACT
BACKGROUND: In this study, we aimed to evaluate the coronary sinus (CS) morphology with three-dimensional transthoracic echocardiography (3D-TTE) in patients with supraventricular tachycardia (SVT) who underwent electrophysiological study (EPS). METHODS: This cross-sectional study was conducted with 187 patients who underwent EPS between November 2016 and April 2017. Patients were divided into three groups: atrioventricular nodal reentrant tachycardia (AVNRT) (n = 72), non-AVNRT SVT (n = 58), and normal EPS (n = 57). All patients were evaluated with electrocardiography, TTE, and 3D-TTE. RESULTS: The CS diameter (CSD) and area (CSA) were found significantly lower in the normal EPS group than in the other groups. There was no significant difference in the CSD between AVNRT and non-AVNRT SVT groups. However, it was found that the CSA was significantly larger in the AVNRT group than in the non-AVNRT SVT group. In linear regression analysis, age and left atrial diameter were determined as independent predictor for CSD and CSA (P < 0.001 for each one). CONCLUSIONS: The CSD and CSA assessed by 3D-TTE were different and dilated in the patients with SVT compared to those in the normal individuals. There was no significant difference in the CSD between the AVNRT and non-AVNRT SVT groups. However, the AVNRT group had a larger CSA than the non-AVNRT SVT group.
ABSTRACT
OBJECTIVE: Epicardial adipose tissue (EAT) secretes various pro-inflammatory and atherogenic substances that have several effects on the heart. The goal of this study was to evaluate the association between EAT thickness and both P-wave dispersion (Pd) and corrected QT interval (QTc), as simple, non-invasive indicators of arrhythmia on a surface electrocardiogram. METHODS: This retrospective observational study included 216 patients who had normal coronary arteries observed on coronary angiography. Each patient underwent 12-derivation electrocardiography to measure Pd and QTc, and transthoracic echocardiography to measure EAT thickness. The patients were divided into 2 groups according to the median EAT value (EAT low group: <5.35 mm; EAT high group: ≥5.35 mm). RESULTS: P-wave dispersion (p=0.001) was significantly greater in the EAT high group compared with the EAT low group. However, the QTc (p=0.004) was significantly greater in the latter group. The median left ventricular end-diastolic diameter (p=0.033), mean left ventricular end-systolic diameter (p=0.039), and mean left atrial diameter (p=0.012) were significantly greater in the EAT high group. Multiple logistic regression analysis using the backward elimination method revealed that the leukocyte count (Odds ratio [OR]: 1.000; 95% confidence interval [CI]: 1.000-1.000; p=0.001), Pd (OR: 1.1026; 95% CI: 1.010-1.043; p=0.002), QTc interval (OR: 0.988; 95% CI: 0.979-0.997; p=0.009), and left ventricular ejection fraction (OR: 0.922; 95% CI: 0.859-0.989; p=0.023) were independently associated with greater EAT thickness. CONCLUSION: Echocardiographic end-diastolic EAT thickness on the free wall of the right ventricle was associated with Pd and QTc in patients with normal coronary arteries.
